Provider Demographics
NPI:1952421604
Name:PERLMAN, BRUCE ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ALAN
Last Name:PERLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 NW 49TH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7266
Mailing Address - Country:US
Mailing Address - Phone:954-777-2022
Mailing Address - Fax:954-777-2021
Practice Address - Street 1:3001 NW 49TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7266
Practice Address - Country:US
Practice Address - Phone:954-777-2022
Practice Address - Fax:954-777-2021
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63641207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Not Answered207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
25204ZMedicare ID - Type Unspecified
F79126Medicare UPIN